Hospice Care for Lung Disease

When to consider hospice for lung disease?

Your loved one has been living with one of several lung ailments, ranging from COPD or chronic asthma to pulmonary or cystic fibrosis. You’ve witnessed the progression of the disease and assured that your loved one has received good medical care. If those treatments are no longer having the effects you both want, it may be time to learn more about hospice care.

Consider that your loved one can be in hospice for months, assuring that care and comfort are available for the remainder of life. Here are some signs that it may be time for hospice:

• You see how much harder it is for your loved one to breathe, despite the oxygen they’re on.
• There’s been weight loss due to a decline in appetite.
• It’s harder and harder for your loved one to talk. They can’t catch their breath and the anxiety that goes with this makes it worse.
• You’ve noticed increased swelling and have read it’s due to reduced lung function, straining a person’s heart.
• Your loved one is in pain so often as their muscles ache and their chest feels so tight.
• Your loved one and family know that further medical treatment is not going to help.
• You’re all seriously thinking it’s best to strive for comfort and as much life quality as possible.

What is the hospice criteria for patients with lung disease?

There is a set of criteria for people with lung disease to be eligible for hospice. Your loved one may meet some of these points as well as others not listed here. Many of the criteria are determined by medical tests that your loved one routinely gets as part of their ongoing care.

COPD hospice eligibility criteria include:

• A lowered level of oxygen in the blood, usually less than 89% on room air.
• A rapid heart rate of over 100 beats per minute, even while resting.
• The right side of the heart has failure because of lung disease.
• Your loved one has noticeable recent weight loss even though they haven’t tried to drop pounds.
• Their breathing is strained and often painful despite being on oxygen around the clock.
• They have bouts of uncontrolled coughing. After that, it’s hard for your loved one to catch even a small breath.
• A physician has determined they have 6 months or less to live.

Are there hospice programs for patients with COPD and other lung diseases?

There are hospice programs that focus on care for people with lung diseases. These include those that:

• Have hospice team members with extra training in caring for people with limited breathing ability. This includes training for physicians, nurses, home health aides, and other staff.
• Team members are skilled at assessing your loved one’s current condition and responding to your concerns. They support you with:
  • Recognizing when to change the flow of oxygen.
  • Using changes in position to promote comfort, especially for breathing.
  • Knowing when to administer medications for the best result.
  • Identifying when a visit by a social worker or bereavement counselor will bring comfort to your loved one or you.

Ask prospective hospice providers about what percentage of their patients have lung disease.

What can hospice do for a patient with lung disease?

Hospice care for people with lung disease focuses on ways to support breathing and comfort while limiting pain and anxiety. Steps that your loved one’s hospice team will take to do this are:

• Preparing a personalized plan of care that addresses your loved one’s and family’s needs.
• Making sure that oxygen and respiratory equipment are available. Hospice team members assess your loved one’s breathing status and make adjustments as needed.
• Demonstrating how to change your loved one’s positioning to improve breathing. They show your loved one breathing techniques that help when feeling short of breath.
• Adjusting medication dosages and times as needed to reduce pain and agitation.
• Having a hospice volunteer visit with your loved one. This allows them to share confidential thoughts they may not be ready to share with you. Or, the volunteer may read to them or offer other options that bring peace.

What can hospice do for the family of a patient with lung disease?

When a loved one has advancing lung disease, it helps caregivers to have direction from hospice professionals about how to be helpful and comforting. When your loved one is in hospice your family benefits from care that:

• Gives you information about how to best care and communicate with your loved one.
• Provides you with opportunities for respite, such as having a volunteer visit your loved one while you go out for fresh air.
• Has team members available for bereavement counseling, social worker services, and nursing visits.
• Has nurses on call during the evening, night, and on weekends. This is comforting as you know you can talk with someone when you have concerns.
• Supports you through difficult days and the end stages of lung illnesses.
• Helps you with accessing the equipment and supplies needed to best care for your loved one.
• Guides you through any rough spots of communicating with family and making decisions for your loved one.

Does Medicare cover hospice for lung disease?

Medicare does cover hospice care for your loved one with lung disease when the specific criteria related to this condition are documented. In addition:

• A physician certifies that your loved one has six or fewer months to live.
• Your loved one no longer pursues curative treatments.
• The hospice agency you choose is Medicare-certified.
• The hospice team manages care, including if your loved one needs to move from one setting to another. An example is a person moving from at-home care to being cared for at a hospice house.

Does Medicaid cover hospice for lung disease?

Each state makes its own decisions about Medicaid eligibility and if it will cover the costs of hospice care. Please check with your state’s Medicaid Office.